Meta-analysis of the application effect of high flow nasal cannula in patients with chronic obstructive pulmonary disease
10.3760/cma.j.cn115682-20220126-00449
- VernacularTitle:经鼻高流量氧疗在慢性阻塞性肺疾病患者中应用效果的Meta分析
- Author:
Qi REN
1
;
Fang CHEN
;
Juan LIN
;
Huijuan ZHANG
Author Information
1. 浙江医院重症医学科，杭州 310030
- Keywords:
Pulmonary disease, chronic obstructive;
High flow nasal cannula;
Non-invasive mechanical ventilation;
Meta-analysis
- From:
Chinese Journal of Modern Nursing
2022;28(26):3565-3574
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the application effect of high flow nasal cannula (HFNC) in patients with chronic obstructive pulmonary disease (COPD) .Methods:Cochrane Library, PubMed, Ovid, CNKI, Wanfang database and other Chinese and English databases were searched for randomized controlled trials or cohort studies on the effect of HFNC in COPD patients. The retrieval time limit was from the establishment of the databases to September 30, 2021. Two researchers independently screened the literature, evaluated quality of the literature and extracted data. RevMan 5.0 software was used to conduct a meta-analysis on the literature that met the inclusion criteria.Results:A total of 8 literatures were included, including 4 English literatures and 4 Chinese literatures, with a sample size of 575 cases. Meta-analysis results showed that there were no statistically significant statistical differences between the HFNC group and the non-invasive mechanical ventilation group patients in the 24-hour heart rate [ WMD=-2.65, 95% CI (-7.17-1.86) , P=0.25], 24-hour mean arterial pressure [ WMD=0.45, 95% CI (-3.10-4.00) , P=0.80], 24-hour arterial partial pressure of oxygen [ WMD=-0.08, 95% CI (-0.89-0.74) , P=0.85], 24-hours arterial blood carbon dioxide partial pressure [ WMD=-0.96, 95% CI (-2.29-0.36) , P=0.15], 24-hour oxygenation index [ WMD=0.87, 95% CI (-4.85-6.58) , P=0.77], length of stay in ICU [ WMD=-0.83, 95% CI (-1.79-0.14) , P=0.09], tracheal intubation rate [ RR=0.98, 95% CI (0.58-1.64) , P=0.93], incidence of aspiration [ RR=0.30, 95% CI (0.08-1.18) , P=0.08]and 28-day mortality rate [ RR=1.12, 95% CI (0.61-2.03) , P=0.72] ( P>0.05) . Compared with non-invasive mechanical ventilation, HFNC could reduce the 24-hour respiratory rate in COPD patients [ WMD=-0.78, 95% CI (-1.48--0.08) , P=0.03], the incidence of nasal and facial pressure injury [ RR=0.14, 95% CI (0.05-0.39) , P=0.000 1] and improved 24-hour arterial blood pH [ WMD=0.03, 95% CI (0.01-0.04) , P<0.01]. Conclusions:Compared with non-invasive mechanical ventilation, HFNC can reduce the 24-hours respiratory rate, the incidence of nasal and facial pressure injury and improve the 24-hours arterial blood pH in COPD patients. However, more high-quality, multicenter randomized controlled trials are needed to verify the results of this study in the future.
